An endoscope is an instrument used to examine the interior of a hollow organ or cavity of the body. They are most typically used to make inspections of the gastrointestinal tract, or the respiratory tract.
Following each use on a patient, the endoscope must be cleaned and reprocessed to achieve the recommended standard of sterilization or high level disinfection to reduce the risk of cross-infection of subsequent patients. Following reprocessing the scopes are to be stored in a manner applicable to the standard of sterilization or high level disinfection, the endoscope is wrapped in a protective wrapper or stored in a suitable scope cabinet ready for the next use.
In order to ensure that endoscopes are being properly sterilized, a microbiological surveillance regimen is typically adhered to. This involves routine testing of endoscopes at fixed time intervals, such as every 4 to 12 weeks. The endoscopes are tested by obtaining a sample from the endoscope channels, the sample is then cultured and analyzed for the presence of bacteria.
The sample is usually obtained using sterile water, a sterile container, and an endoscope brush in the following manner:                Sterile water is flushed into each of the channels to be brushed, and any water which emerges from the distal tip is collected.        The brush is inserted into the biopsy channel of the endoscope, withdrawn and swirled in the water in the sterile container        Remaining brushable channels such as the suction channel of the endoscope are brushed and brush swirled in collection device again.        Using a sterile syringe, sterile water is flushed under positive pressure through each of the channels in turn. Flushing is performed from the connection points in the light guide plug and flow to the distal tip. Fluid is flushed until it emerges from the tip.        Air is then syringed through to empty the remaining fluid from each of the channels. The total rinse fluid is collected in the sterile container.        The container is sealed, labeled, and sent for testing.        
Throughout the sampling procedure, attention must be paid to preventing the tip of the endoscope from touching the container so as to avoid contamination. Furthermore, the body of the endoscope must be kept in a raised position with respect to its distal end to ensure that fluid flows in the intended direction, towards and out of the distal end. This means that the sampling procedure must be carried out by a team of two people. One person stands at a raised position, such as by standing on a chair, and introduces the sterile water. The second person holds the distal end of the endoscope at the mouth of the sterile container to collect water emanating from the tip of the endoscope.
Furthermore, the mouth of the sterile container is open to the air during the sampling procedure, which gives rise to a risk of false positive test results, which in turn necessitate a repeated and unnecessary test of the same endoscope.
Similar issues are experienced in sampling procedures carried out other types of medical equipment, such as dialysis machines.
There remains a need for improvements in procedures for obtaining samples from medical equipment.